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目的 探讨后腹腔镜手术治疗肾上腺疾病的适应证及手术方法。 方法 应用后腹腔镜手术治疗肾上腺疾病 4 5例 4 6侧 ,其中原发性醛固酮增多症 19例 ,皮质醇增多症 15例 16侧 (腺瘤 10侧 ,增生 6侧 ) ,无功能腺瘤 8例 ,肾上腺囊肿 3例。 结果 4 5例 4 6侧手术中 ,4 4例手术成功 ,1例因术中出血和粘连改开放手术。手术时间平均 10 5 (6 0～ 2 70 )min。术中出血平均 30 (10～ 10 0 )ml,均未输血。患者术后 1～ 2d恢复进食 ,并可下床活动。术后住院时间平均 6 .8(4～ 19)d。 结论 与开放手术相比 ,后腹腔镜手术具有创伤小 ,疼痛轻 ,康复快等优点 ,已成为肾上腺良性疾病的首选手术方法
Objective To investigate the indications and surgical methods of retroperitoneal laparoscopic surgery for adrenal diseases. Methods Retroperitoneal laparoscopic surgery was performed in 45 cases and 46 sides of adrenal diseases, including 19 cases of primary aldosteronism, 15 cases of 16 cases of cortisol hypersecretion (10 cases of adenoma, 6 cases of hyperplasia), 8 cases of non-functioning adenoma Cases, adrenal cysts in 3 cases. Results In 45 cases of 46 operations, 44 cases were successfully operated and 1 case was changed to open operation due to intraoperative bleeding and adhesions. The average operation time was 105 (60 ~ 270) min. Intraoperative bleeding average 30 (10 ~ 10 0) ml, no blood transfusion. Patients recover after eating 1 ~ 2d, and get out of bed activity. The average postoperative hospital stay was 6.8 (4-19) days. Conclusion Compared with the open surgery, retroperitoneal laparoscopic surgery has the advantages of less trauma, less pain and quick recovery, which has become the preferred surgical method for benign adrenal diseases